Inquest to probe Toowoomba Hospital drug addict nurse death

Stuart Cumming
Reporter
Stuart studied journalism at the University of Southern Queensland in Toowoomba. He worked briefly at Central Queensland News and Warwick Daily News. He has worked as a reporter at The Chronicle since July 2009.

THE death of a drug-addicted nurse has sparked a coronial inquest into the professional supervision the Toowoomba woman was under.

A pre-inquest hearing before Coroner Christine Clements in Brisbane Magistrates Court yesterday heard details of the circumstances leading up to the death of wife, mother-of-two and Toowoomba Hospital critical care nurse Katie Lee Howman.

Counsel assisting the Coroner Dr Anthony Marinac said Mrs Howman was 30-years-old when she injected herself with a fatal dose of the opioid Fentanyl at her home on the morning of December 21, 2013.

He said Fentanyl was an opioid many times stronger than morphine or even heroin.

"She died shortly afterwards and was discovered by her husband when he returned home at lunch time," Dr Marinac said.

It was not the first time Mrs Howman had injected herself with the drug.

The court heard that on January 13, 2010, Mrs Howman had taken Fentanyl from a patient and injected while at work as a Toowoomba Hospital nurse.

"On that occasion, she also overdosed and was saved by the quick actions of her hospital colleagues."

Mrs Howman was formally suspended from practice on March 9, 2010, and allowed to return to practice on August 6.

She was subject to limitations including supervision, a prohibition on contact with drugs of addiction and frequent drug screening.

Dr Marinac said Mrs Howman had seen a psychologist and a psychiatrist before returning to work from suspension for treatment of anxiety and depression.

He said she also had a number of other medical issues, particularly in relation to her hips.

The court heard Mrs Howman became addicted to opioids Tramadol and Oxycodone prescribed in the management of her pain and acquired the drugs through a process of "doctor shopping".

At its height, Mrs Howman obtained, between October and December, 2012, more than 750 Oxycodone tablets of varying strength from 11 doctors.

"All told, between the end of 2010 and her death in December, 2013, Mrs Howman obtained a total of more than 3000 Tramadol and Oxycodone tablets from no less than 30 different doctors in the Toowoomba area."

Dr Marinac said this occurred despite Mrs Howman's ongoing professional supervision and her ongoing submission to routine drug testing.

Those to be summonsed to appear at the inquest included Mrs Howman's husband Heath, her family doctor, psychiatrist and psychologist as well as representatives from Toowoomba Hospital, the Australian Health Practitioner Regulation Agency and the Queensland Nurses Union.

Mr Howman yesterday said he would be trying to remain in the background of the inquest.

"I just hope something positive comes out of it," he said.

Darling Downs Hospital and Health Service Chief Executive Dr Peter Bristow said the organisation would fully cooperate with the coronial inquest.

"The death of Mrs Howman was a tragedy and I would like to extend my sympathies to her family and friends," Dr Bristow said.

He said the process was to help prevent similar deaths in the future where that was possible. Senior hospital staff attended yesterday's pre-inquest hearing and expected to attend the inquest next month.

"Since this matter is before the coroner, we are unable to make any further comments."

The inquest was set to proceed in Toowoomba on February 23 and 24.

Focus of inquest

- Whether the processes for dispensing and disposing of Schedule 8 drugs, including Fentanyl, were appropriate at Toowoomba Hospital at the time of Mrs Howman's death;

- Whether there were opportunities for Mrs Howman to obtain Fentanyl directly from patients under her care, after the drugs had been properly dispensed;

- Whether Mrs Howman was properly supervised, and whether the process of supervision was sufficient;

- Why the process of drug testing was unable to detect that Mrs Howman was systematically abusing opiates;

- Whether Mrs Howman's history of NHS prescriptions was ever monitored during her professional supervision, and if not why not; and

- Whether it is easy or difficult for nursing and other medical staff, who may be addicted to some form of drugs, to obtain syringes and needles from their workplace.

- Whether the final, fatal injection of Fentanyl was suicidal or inadvertent; however it was foreshadowed that counsel had no evidence to bring to suggest any suicidal ideation, other than Mrs Howman's general mental health background.